Healthcare Provider Details
I. General information
NPI: 1346376332
Provider Name (Legal Business Name): TSHC PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2260 THIELEN STUDENT HEALTH CENTER UNION & SHELDON
AMES IA
50011-2260
US
IV. Provider business mailing address
2260 THIELEN STUDENT HEALTH CENTER UNION & SHELDON
AMES IA
50011-2260
US
V. Phone/Fax
- Phone: 515-294-5802
- Fax: 515-294-5457
- Phone: 515-294-5802
- Fax: 515-294-5457
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GREG
YEAKEL
Title or Position: PHARMACIST
Credential:
Phone: 515-294-4041